Patient-reported outcome measures in spine surgery

Abstract

Background: Steadily increasing expenditure in the United States health-care system has led to a shift toward a value-based model that focuses on quality of care and cost-effectiveness. Operations involving the spine rank among some of the most common and expensive procedures performed in operating rooms nationwide. Patient-reported outcomes measures (PROMs) are a useful tool for reporting levels of outcome and analyzing patient recovery but are both under-utilized and nonstandardized in spine surgery. Methods: We conducted a systematic review of the literature using the PubMed database, focusing on the most commonly utilized PROMs for spine disease as well as spinal deformity. The benefits and drawbacks of these PROMs were then summarized and compared. Results: Spine-specific PROMs were based on the class of disease. The most frequently utilized PROMs were the Neck Disability Index and the modified Japanese Orthopaedic Association scale; the Oswestry Disability Index and the Roland-Morris Disability Questionnaire; and the Scoliosis Research Society 22-item questionnaire (SRS-22) for cervicothoracic spine disease, lumbar spine disease, and spinal deformity, respectively. Conclusion: We found limited, though effective, use of PROMs targeting specific classes of disease within spine surgery. Therefore, we advocate for increased use of PROMs in spine surgery, in both the research and clinical settings. PROM usage can help physicians assess subjective outcomes in standard ways that can be compared across patients and institutions, more uniquely tailor treatment to individual patients, and engage patients in their own medical care.

Patient‐reported outcome tools in musculoskeletal oncology

“…These evaluation tools all have the benefit of coming from the patient perspective and have been widely reported in the literature. These scoring tools have been involved in improving clinical practice in their respective subspecialties through quantifying patients’ perceptions of their physical function and standardized reporting of patient outcomes 29–31 . However, these scoring tools are not specific for the musculoskeletal oncology patient population.…”

Arabic-Translated Versions of Patient-Reported Outcome Measures Utilized in Spine Research: A Review of Validated Studies

“…Some of the tools reviewed here are recognized to be amongst the most commonly used in spine research in the literature. These include RMDQ [ 4 - 6 , 8 , 9 ], ODI [ 4 - 6 , 8 , 9 ], FABQ [ 4 , 5 ], BBQ [ 5 ], SRS-22 [ 4 , 5 , 8 ], NDI [ 4 , 5 , 8 ], QBPDS [ 5 , 6 , 8 ], MPQ-SF [ 5 , 9 ], Japanese Orthopaedic Association (JOA) Scale [ 4 , 5 , 8 ], Tampa Scale of Kinesiophobia (TSK) [ 4 , 5 ], Core Outcome Measure Index (COMI) [ 5 , 8 ], Orebo Musculoskeletal Pain Questionnaire [ 8 ] and the Bournemouth Questionnaire [ 8 ]. A notable absence from the list of 26 PROMs shown in Table 2 were four tools that are used in spine research.…”

“…A notable absence from the list of 26 PROMs shown in Table 2 were four tools that are used in spine research. These are Short Form-36 (SF-36) [ 4 , 5 ], Visual Analogue Scale (VAS) [ 4 , 5 ], EuroQol-5D (EQ-5D) [ 5 ], and Zurich Claudication Questionnaire (ZCQ) [ 5 , 8 ]. Three of these instruments (SF-36 [ 1 , 2 , 51 ], EQ-5D [ 3 , 52 ] and NRS [ 53 ]), had Arabic-translated versions but they were not included in this review because their validation was in random population and in not spine research.…”

“…Guzman et al [ 5 ], identified 206 tools that were used in studies that were published in five spine journals from 2004 to 2013. Beighley et al [ 8 ] named 37 spine-specific PROMs that were utilized the spine disease and deformity literature. Ramasamy et al [ 9 ] found 176 PROMs that were employed in chronic back pain research during 2011 and 2015.…”

Discrepancies in recommendations for return to regular activities after cervical spine surgery: A survey study

“…While multiple goals of spine surgery exist – decreasing pain and disability, improving deformity, minimizing postoperative complications, and minimizing cost, the primary objective is always to improve the patient's quality of life [3 , 4] . When assessing quality of life, the most basic measure to consider is a patient's ability to partake in activities of daily living, with the lack of capacity to perform these activities a proven indicator of disability that ultimately affects patient satisfaction [5] . Moreover, after surgery, a large percentage of patients expect to return to their preoperative levels of function, that may include activities such as driving, exercise, and, oftentimes, work [6] .…”